Piracetam

General characteristics. Structure:

Active agent: piracetam 0,2g.

Excipients: potato starch, povidone, magnesium a carbonate, calcium stearate - before receiving a tablet weighing 0,25 g (without cover).

Excipients: sucrose (sugar), povidone, magnesium a carbonate, silicon dioxide colloid (aerosil), titanium dioxide, dye tropeolin Oh, of sunflower oil, beeswax, – enough before receiving a tablet weighing 0,46 g (with a cover).

Description: tablets, coated, yellow color, round, biconvex form. On cross section two layers are visible.

Pharmacological properties:

Pharmacodynamics. Piracetam is nootropic  means, exerts positive impact on exchange processes of a brain: increases concentration of ATP in brain fabric, strengthens biosynthesis of RNA and phospholipids, stimulates 
glycoclastic processes, strengthens glucose utilization. Drug improves integrative activity of a brain, promotes memory improvement, has protective action at various forms of a cerebral hypoxia, facilitates training process.

Improves bonds between cerebral hemispheres and synaptic conduction in neocortical structures, recovers and stabilizes cerebral functions, especially consciousness, memory and the speech, increases intellectual working capacity, improves a brain blood stream.

Pharmacokinetics. After intake piracetam is well soaked up and gets into various bodies and fabrics. The maximum concentration of drug in blood of the person is observed in 1 hour after reception. Gets through a blood-brain barrier, collects in brain fabric, in internals. In brain fabric collects in 1-4 hours. Out of cerebrospinal fluid it is brought much more slowly, than out of other fabrics that testifies to high tropism to brain fabric. In an organism piracetam is practically not exposed 
biotransformation is also allocated with kidneys in an invariable look.

The elimination half-life makes 4,5-5 hours. Bioavailability irrespective of a dosage form makes about 100%. 

Indications to use:

Piracetam is applied in neurologic, psychiatric and narcological practice.

In neurologic practice piracetam is applied mainly, at the vascular diseases of a brain (atherosclerosis, hypertensive encephalopathy, vascular parkinsonism) with the phenomena of chronic cerebrovascular sufficiency which are followed by disturbances of memory, attention, the speech, dizziness, a headache; during recovery therapy at disturbances  of cerebral circulation, after coma and subcomas,  brain injuries and intoxications for the purpose of increase in motor and mental performance of patients.  

Piracetam is also applied at patients with  the diseases of a nervous system accompanying with decrease intellectual мнестических functions and disturbances of the emotional and strong-willed sphere. 

In psychiatric practice piracetam is applied at patients with neurotic depressions of various genesis with dominance in a clinical picture of an adynamia, asthenic and senesto-hypochiondrial disturbances, the phenomena of ideatorny block, and also at therapy of sluggish and apathetic defective states, senile and atrophic processes, in complex therapy of the mental diseases proceeding on "integrally defective soil". Besides, piracetam is applied as supportive application at treatment of depressions, resistant to antidepressants, and also at bad portability of neuroleptics and other psychotropic drugs, for the purpose of elimination or prevention of the somatovegetativny, neurologic and mental complications caused by them. As supportive application piracetam can be applied at epilepsy. 

In narcological practice drug is used at treatment of an alcoholism with the phenomena of permanent disturbances of mental activity (an adynamy, intellectual мнестические disturbances, etc.).

Indications at children. If necessary to accelerate training process, at an oligophrenia, a delay of intellectual development, cerebral palsy.

Route of administration and doses:

Piracetam on 0,2 g  is applied inside to food, since a daily dose of 1,2 g (on 0,4 g 3 times a day) and bring to 2,4 g, sometimes to 3,2 g and more. The therapeutic effect in these cases is noted, as a rule,  in 2-3 weeks from an initiation of treatment. In the subsequent the dose is reduced to 1,2-1,6 g (0,4 g 3-4 times a day).

The maximum daily dose for adult 4-6 g and more.

The course of treatment is continued from 2-3 weeks to 2-6 months. If necessary the course of treatment is repeated.

Doses for children: from 1 year to 5 years – on 0,2 g 3 times a day; from 5 to 16 years – on 0,4 g 3 times a day.

Course of treatment – from 2 weeks to 2-6 months.

Features of use:

Treatment by piracetam if necessary can be combined using psychotropic, cardiovascular and other medicines.

At treatment of acute damages of a brain piracetam is appointed in a complex with other methods of disintoxication and recovery therapy, and at treatment of psychiatric diseases – with the appropriate psychotropic drugs.

It is necessary to be careful during the work with mechanisms.

Side effects:

At use of piracetam the acrimony, nervousness, uneasiness, excitement, a sleep disorder, a headache, dizziness, a gastralgia, dispepsichesky frustration (nausea, vomiting, diarrhea, a lock, anorexia), increase in sexual activity, extrapyramidal disturbances, spasms, a tremor, deterioration in a course of stenocardia are possible.

At children, especially mentally retarded: fussiness, uneasiness, restlessness, motive disinhibition, decline in the ability to concentration of attention, disbalance, irritability, the raised conflictness.

In these cases it is necessary to reduce a dose or to stop administration of drug.

Side effects are most often noted at doses higher than 5 g/days.

Interaction with other medicines:

Simultaneous use of piracetam with the medicines stimulating the central nervous system, usilivayety effects with  antipsychotic means (neuroleptics) – amplifies their central action (a tremor, concern, etc.).

Piracetam strengthens effect of peroral anticoagulants, increases efficiency of hormones of a thyroid gland, reduces efficiency of antiepileptic drugs (reduces an epileptic threshold).

Contraindications:

Individual intolerance of drug; a heavy renal failure (KK less than 20 ml/min.), a depression with concern (the agitated depressions), a chorea of Gentington; pregnancy and a lactation, children's age till 1 year.

Overdose:

At overdose there can be strengthening of possible side effects. First aid: gastric lavage, reception of absorbent carbon.  Treatment: symptomatic.

Storage conditions:

List B. In dry, protected from light and the place, unavailable to children.

Period of validity 3 years. Not to use after the term specified on packaging.

Issue conditions:

According to the recipe

Packaging:

On 60 tablets in bank from glass melt or on 10 tablets  in a blister strip packaging. To one bank or 6 planimetric packagings in a pack.